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Increased nurse staffing levels could be the key to helping hospitals avoid reimbursement penalties for avoidable readmissions, suggests a new study tying rehospitalizations of Medicare patients to staffing ratios.

The research, published in the October Health Affairs journal, studied Medicare beneficiaries who had suffered heart attacks, heart failure, or pneumonia and were readmitted at more than 2,800 hospitals in conjunction with those hospitals’ nurse staffing levels.

Hospitals with higher nurse-to-patient ratios had 25% lower odds of being penalized for readmissions, researchers at the University of Pennsylvania found, compared to those with lower nurse staffing ratios.

In fiscal year 2013, hospitals were fined about $280 million in penalties for avoidable readmissions.

For each additional nurse hour per patient day, the hospital gained a 10% lower odds of receiving penalties from the Affordable Care Act’s Hospital Readmissions Program, the researchers estimated.

“Our findings highlight a component of the hospital care delivery system that can be targeted to limit hospitals’ exposure to readmissions penalties while improving patient outcomes,” the authors wrote. “By focusing on a system factor such as nurse staffing, administrators may be able to address multiple quality issues while reducing their likelihood of penalty for excess readmissions.”

Nurses are responsible for many activities believed to reduce preventable readmissions, such as care coordination post-discharge, overseeing in-hospital care, and planning patients’ discharge from the hospital and post-discharge medication routine.

While it’s intuitive that adequate staffing and resources would help readmission rates decline, the researchers say hospitals should take note of their findings.

“This study strongly supports the idea that nurse staffing is one key component of healthcare delivery that hospitals can address to both improve patient outcomes and reduce the likelihood of being penalized for excessive readmissions.”

A California-based laboratory and radiology company will pay $17.5 million for falsely billing Medicare and Medi-Cal, the state’s Medicaid program, by charging skilled nursing facilities discounted rates for inpatient services in exchange for outpatient referrals.

The payment will settle allegations that Kan-Di-Ki LLC, dba Diagnostic Laboratories and Radiology, violated federal and state False Claims Acts by paying kickbacks for referral of mobile lab and radiology services for which it sought federal and state reimbursement, says the Department of Justice.

“This settlement demonstrates the Department of Justice’s continuing efforts to protect public funds,” said Stuart F. Delery, Assistant Attorney General for the Civil Division. “We will continue to work with our state partners to recover misspent monies from companies that abuse government health care programs.”

Medicare reimburses inpatient and outpatient services differently, and Diagnostic Labs allegedly charged skilled nursing facilities in California discounted rates for inpatient services in exchange for those facilities to refer outpatient business to the lab and radiology company.

Outpatient services are reimbursed on a per-episode basis by Medicare, while the federal program pays for inpatient services on a fixed rate based on the patient’s diagnosis, regardless of what services have been provided.

Diagnostic Labs’ scheme helped participating skilled nursing facilities to maximize the profit earned for providing inpatient services as they were being charged less for lab and radiology services. Then, Diagnostic Labs was able to access a “steady stream lucrative outpatient referrals,” says the Justice Department, that could be directly billed to Medicare and Medi-Cal.

The nearly $18 million settlement resolves a lawsuit filed by former Diagnostic Lab employees, Jon Pasqua and Jeff Hauser, under the whistleblower provisions of the federal and state False Claims Acts. The two former employees will receive nearly $3.8 million as their share of the federal government’s recovery.

“This support allows us to examine what role senior living providers have in the new models of care that have emerged under health care reform,” David Grabowski, PhD, a professor of health care policy at HMS who is leading the research study, said in a statement.

The research is based on the premise that senior living community residents often need an array of health and supportive services in order to maintain the best quality of life, but many times they receive fragmented care from multiple providers and payers.

This can result in unnecessary healthcare expenditures and lower quality of care, so Grabowski and his team will examine whether providing more comprehensive, coordinated services in the senior living sector reduces the need for Medicare-reimbursed services and Medicaid-financed nursing home care.

The United States’ ability to meet the needs of its aging population is an important political, economic, clinical, and social imperative, says Will Clark, Brookdale’s senior vice present of strategy and brand, and a member of the HMS Health Care Policy Advisory Council.

“Harvard’s reputation for tackling some of health care’s biggest challenges and generating meaningful insights that shape our nation’s policy is unparalleled,” said Clark. “We are confident Dr. Grabowski and his colleagues’ research will be influential in determining the appropriate role senior living can and should play in our evolving health care system.”

Goals of the research initiative include creating awareness for the potential senior living has to positively impact the health, well-being, and overall cost of care for seniors; identifying barriers to creating more integration among senior living and the healthcare system; influencing policy; and identifying innovative models that integrate senior living with the healthcare system, says Brookdale.

The two-phase study will begin with analyzing the role of assisted living in new payment-delivery models, and presenting a conceptual model of how an intergrated model might work, as well as the opportunities and challenges associated with such an approach. Then, with the results of the first phase as a foundation, the second phase of the project will consist of primary data work and potentially the development of a pilot program.

Brookdale has previously taken part in a pilot deploying the INTERACT program in senior living settings after winning a $7.3 million grant in partnership with the University of North Texas Health Science Center from an Affordable Care Act initiative funding healthcare innovators.

“A year after Chaparelle House closed its doors, the assisted living facility received its license back and is reopening. In April 2012, the Idaho Department of Health and Welfare revoked the license for the Twin Falls assisted living facility, which forced 18 residents to find new homes,” reports the Times-News. “State surveyors determined the facility wasn’t employing enough staff, Idaho Department of Health and Welfare spokesman Tom Shanahan told the Times-News last year. Prior to recent administrative changes, there were 10 complaints filed against parent company Assisted Living Concepts [NYSE:ALC] between 2009 and 2011.” Read more…

“What’s the gap between breaking even and making money on the average patient in a rural South Dakota nursing home? About $30 to $40, according to many nursing home officials interviewed in The Daily Republic’s print circulation area. That’s the difference, they say, between Medicaid reimbursements and the actual cost to provide care for residents,” reports The Daily Republic. ”Rural nursing homes in South Dakota are largely dependent on state and federal funding to provide care for residents, leaving little left left over to provide extra amenities and upgrades.” Read more…

According to a spokesman for the [Connecticut Department of Public Health], the department’s licensing and investigations unit “recently reviewed and updated the financial penalties it levies against nursing homes for the various classes of violations it issues.” The fines were generally doubled,” reports the Hartford Courant. “[Spokesman William] Gerrish said the federal Centers for Medicare & Medicaid Services (CMS) recently updated their civil penalties, and ‘we felt it was also appropriate for us to review and update the penalties we had been levying under our state jurisdiction. Because the fines had remained at the same level for many years, DPH felt it was time to increase their level to bring them into alignment with today’s economy and make them a more effective regulatory tool, he said.” Read more…

“Florida lawmakers are pushing for sweeping deregulation of the nursing home industry that would protect owners and investors from financial penalties resulting from lax patient care,” reports the Herald Tribune. “The overhaul comes as advocates for seniors say loose government oversight has already weakened standards for care of the elderly in a state considered the nation’s nursing home capital. Lobbied for by nursing home investors, who have financially backed the campaigns of several GOP lawmakers, Senate Bill 1384 would stop all patient lawsuits at the direct management level.” Read more…

“Town health officials Sunday abruptly closed the Blackstone Nursing & Rehabilitation Center and ordered the evacuation and relocation of the nursing home’s 25 residents after it was discovered the Butler Street facility had been without heat and hot water since Thursday afternoon. Town officials were tipped off about conditions at the facility after the daughter of one resident went to visit her mother Sunday and saw her and other residents sitting around wearing coats and eating off paper plates. The facility had no heat or hot water due to a cracked boiler plate,” reports The Woonsocket Call. “The 25 residents were brought to various nursing facilities owned and managed by the same company that owns the Blackstone facility—Norwood, Mass.-based Rehabilitation Associates, which operates nine small rehabilitation and skilled nursing centers, as well as an outpatient rehabilitation center.” Read more…

“Minnesota’s nursing home and long-term care workers would get small salary increases in a health spending bill up in the Minnesota House,” reports the St. Cloud Times. “The raises are 3 percent for nursing home workers and 2 percent for long-term care workers. The Democratic-sponsored, $5 billion health and human services budget is on the House floor Monday.” Read more…

“The Oklahoma House has approved a bill that says people can’t be denied residence or kicked out of nursing homes if they or their families place cameras in their rooms,” reports the Associated Press. “The bill passed without opposition Monday. It now goes back to the Senate for further consideration.” Read more…

“California nursing homes reduced unnecessary use of antipsychotic medications by 8.5 percent last year, making better progress on the initiative than 39 other states, but not meeting the targeted 15 percent drop,” reports the Sacramento Business Journal. “California nursing homes reported a 19.3 percent average use of antipsychotics, below the national average of 22.9 percent.” Read more…

“State officials have suspended enrollment in New York’s largest managed long-term care plan for frail elderly and disabled people, and investigators have begun examining the relationships between such plans, which are financed by Medicaid, and the social adult day care centers that send them new customers,” reports The New York Times. “On Thursday, investigators from the Medicaid fraud control unit of the state attorney general’s office were in Brooklyn gathering evidence that some centers had persuaded seniors to sign up with incentives like free takeout food, casino visits and cash before steering them to managed care companies eager to enroll them in plans designed for older people with long-term needs like home health care and nursing.” Read more…

“At its regularly scheduled meeting Thursday night, Travelers Rest City Council unanimously approved an ordinance to annex Furman University and Furman Foundation properties into its city limits. This was the second and final reading of the ordinance, which was approved on first reading in March,” reports the Travelers Rest Tribune. “Multiple properties—including the university campus, the golf course, the Vinings at Duncan Chapel apartments and the Woodlands at Furman retirement community—are included in the annexation. The annexation will increase the size of Travelers Rest by over 900 acres, about one-third of its current size.” Read more…

“Twenty-eight states have adopted strategic Alzheimer’s plans to address what many view as the biggest scourge afflicting the elderly population, but Pennsylvania — the fourth-grayest state in the country — is not among them,” reports the Post-Gazette. ”The Corbett administration is attempting to acknowledge the disease now with appointment of a broad Alzheimer’s Disease State Planning Committee charged with producing recommendations by February.” Read more...

Here’s a collection of news bites pertaining to the senior housing and long-term care industries, gathered from around the nation. Many of the articles are state-specific, but could eventually have national implications or influence senior care trends. Click the links to access the full article.

“Without financial support, the federal government’s new unpaid and volunteer long-term care commission is likely to do little more than produce yet another report about the challenge of providing care for an aging nation, experts said,” writes MedPage Today. “‘At the end of the day, it will be another report that will sit in the Library of Congress collecting dust,’ said Jesse Slome, executive director of the American Association for Long-Term Care Insurance. ‘But one day this will have to be addressed … because you can only kick the can down the road for so long.’” Read more…

“Rep. Nelson Dollar, a Cary Republican, filed a bill last week that would allow people with Alzheimer’s disease and other forms of dementia to receive as much as 130 hours of personal care services each month. The increase would require approval from the legislature and the federal agency that oversees Medicaid and Medicare,” reports the NewsObserver.com. “The new Medicaid rules limit personal care to 80 hours a month per resident. Adult-care home operators say they were sending in bills for 124 hours a month, on average, for those residents under previous guidelines. The legislature allowed operators to tap in to a state fund to help bridge the gap, but that money runs dry on June 30.” Read more…

“Age may be finally catching up with The Villages, the sprawling retirement haven for the over-55 that promises recreational activities “beyond imagination.” It needs nursing homes,” reports the Orlando Sentinel. “Proposed bills in the Legislature would allow developers of the community with 100,000 residents to build nursing homes, adding up to 240 bed spaces, despite the state’s moratorium on new nursing-home beds.” Read more…

“Despite being one of the highly-ranked nursing homes in Massachusetts and nationwide, Tuell Nursing Home will be shuttering as soon as the end of next week, according to co-owner Michael Cummings,” reports the Melrose Patch. “With rising costs and no state increases in the past handful of years, Cummings explained said there was no other alternative but to close. Cummings, who has worked as an operator and owner in the industry since 1981, said the past two years have been the most challenging running Tuell given the reduced funding at the state level.” Read more…

“The management company for a for-profit Galloway Township nursing home and pediatric care center filed a mass layoff notice for 212 employees in preparation for a sale to another company that will run both facilities,” reports the Press of Atlantic City. “The Health Center at Galloway and the Pediatric Day Health Center at Galloway are owned by Cherry Hill-based Seniors Management North, a privately owned health care management company. Both facilities are located at 66 W. Jimmie Leeds Road, which was assessed at $10 million last year, according to tax records.” Read more…

“The state this week levied a $36,000 fine against Avante at Ormond Beach nursing home for its handling of a sexual abuse allegation. Inspectors with the Florida Agency for Health Care Administration found the nursing home did not properly report an allegation that an employee crawled into bed with a patient,” reports The Daytona Beach News-Journal. “The fine is considerable by state standards, where the most serious offenders typically see fines of about $40,000, said Brian Lee, executive director of Families for Better Care, an organization that advocates for nursing home residents and their families.” Read more…

“A three-year grant of $574,208 from the Missouri Foundation for Health will provide safety culture and Patient Safety Organization (PSO) services for Missouri long-term care (LTC) facilities through the Center for Patient Safety,” reports St. Louis Today. “The PSO plan for LTC facilities includes initiatives to improve awareness of resident safety and the ability of participating organizations to improve their resident safety programs. The Center will provide resources to help them meet anticipated federal requirements. Because it also works with hospitals and EMS providers, the Center can help long-term care facilities provide safer care in collaboration with other providers.” Read more…

“Considering the need of area nursing homes and long-term care facilities to retain and recruit employees, the proposed $150 million in Health and Human Services cuts to fix the state deficit would have a negative impact on the local economy, said Rep. Bud Nornes, R-Fergus Falls,” reports the Fergus Falls Journal. “Nornes said the cuts would mean that nursing home administrators, which were hoping to receive the state funding that would allow for a five percent increase, would likely receive only a 2 percent increase, not all of which would be dedicated to wage increases.” Read more…

Here’s a collection of news bites pertaining to the senior housing and long-term care industries, gathered from around the nation. Many of the articles are state-specific, but could eventually have national implications or influence senior care trends. Click the links to access the full article.

From the judgment: “Though Appellant is correct that it was HCR’s burden to establish his ability to support his mother, we hold that HCR met its burden. As a result, Appellant’s first request for a new trial is without merit.” Read more…

“House Bill 73, a bill that would continue a criminal background check program for nursing home employees, was passed by the House but was never heard by a Senate committee. If a similar bill isn’t passed in the 2014 session, the fingerprint background check program—currently paid for through a $3 million federal grant and an additional $1 million in state funds—will end after June 30, 2014,” reports Kentucky.com. “Bills that would create a registry of workers who have had substantiated cases of adult abuse or neglect also failed to pass for the fourth straight year. Gov. Steve Beshear had earmarked $1.2 million in the 2012-2014 budget for the creation of the adult abuse registry.” Read more…

“Governor Deval Patrick held a ceremonial bill signing Wednesday for legislation that will give residents of continuing care retirement communities additional consumer protections and housing rights,” reports EnterpriseNews.com. “The legislation will give residents of Continuing Care Retirement Communities the right to establish a resident’s association, receive a current copy of the facility disclosure statement and receive information on fees and construction. Providers must make reasonable efforts to explain the terms of disclosure statements, adjustments in monthly fees, information that may affect the health and welfare of residents and the future of the facility, including the ownership and providers’ financial health.” Read more…

“[On Tuesday,] a legislative committee unanimously passed a bill that would allow nursing home residents or their family members to put video recorders in their rooms,” reports NewsOK.com. “[The bill] also would prohibit a nursing home facility from refusing to admit a person who wants a recording camera in the room or remove a resident because a camera is in the room. Backers are confident Senate Bill 587 will get eventual approval of the full House. It was approved in the Senate 44-0.” Read more…

“A state appeals court has overturned a verdict against a Bridgewater nursing home accused of firing a nurse in retaliation for him reporting allegedly improper patient care to government agencies in January 2008,” reports NJ.com. “Jurors in March 2012 agreed with the claim made by James Hitesman that his termination from Bridgeway Senior Healthcare violated the Conscientious Employee Protection Act, or CEPA, which is designed to protect employees in whistle-blower cases. But the appellate judges found that since the code of ethics only applies to nurses, it cannot be cited as part of a CEPA claim against Bridgeway.” Read more…

“Broadfield Care Center at 7927 Middle Ridge Road sent a letter to its residents Thursday notifying them its skilled nursing facility will close in 90 days,” reports The News-Herald. “Provider Services, which bought Broadfield three years ago, issued a statement Friday. The statement didn’t provide a reason as to why the 81-bed facility is closing. No plans have been made on what will happen to the facility and its 80 skilled nurses.” Read more…

A bill spawned by the controversial Rocky Hill nursing home proposal cleared one legislative committee and was forwarded to a second on Tuesday. In its current form, the bill would amend existing state law to prohibit people convicted of sexual assault, along with convicted murderers, from residential nursing home placement,” reports the Hartford Courant. “If it becomes law, and is not vetoed by Gov. Dannel P. Malloy, the bill would take effect at enactment.” Read more…

“The Texas Senate unanimously approved an overhaul of long-term and acute care Medicaid services on Monday in an effort to expand care to more disabled Texans while saving millions of state dollars. “We cannot continue to fund the same inefficient, unsustainable long-term care system and expect a different result,” said Sen. Jane Nelson, R-Flower Mound, the author of Senate Bill 7,” reports the News-Journal.com. “SB 7 is expected to save $8.5 million in Medicaid costs in the 2014-15 biennium by expanding managed care services, establishing pilot programs to try to provide services at capitated costs and implementing measures to ensure more efficient monitoring of services.” Read more…

“Senior citizens and physically handicapped people gathered at the Statehouse on Wednesday to share the importance of home and community-based services that can help keep people in their own home, instead of having to move to a long-term care facility,” reports the Post-Tribune. “At the Rally for Independence, Indiana residents from all corners of the state gathered to show how a little funding to help those who would prefer to stay home on their own goes a long way.” Read more…

“[On March 28], California’s Department of Health Care Services (DHCS) and the federal Centers for Medicare and Medicaid Services (CMS) announced an agreement to redesign the way Medi-Cal and Medicare services are delivered to low-income older adults and people with disabilities in California,” says the National Senior Citizens Law Center. “Under the agreement, dual eligibles will be automatically enrolled into capitated managed care plans responsible for delivering all Medicare and Medi-Cal services in exchange for a single payment. The payment will be less than the two programs spend on the population today. Enrollment will begin this October. As many as 456,000 people will be impacted.”

Here’s a collection of news bites pertaining to the senior housing and long-term care industries, gathered from around the nation. Many of the articles are state-specific, but could eventually have national implications or influence senior care trends. Click the links to access the full article.

“Wisconsin’s nursing homes have descended into deregulated chaos. The industry now combines all the worst elements of a monopolistic business model with the basic bureaucratic inhumanity of a spread sheet,” reports Esquire. “What regulations are still in place are paralyzed because there aren’t enough investigators to make them function. And the most obvious remedy outside government — the threat of huge penalties deriving from civil judgments — has been defanged by the tort reform bill.” Read more…

“Mercy Health is closing Mercy Franciscan Terrace nursing home, leaving 134 patients to find another place to live. Mercy Health parent Catholic Health Partners and the Franciscan Sisters of the Poor determined that current and future capital outlay needs were prohibitively high, according to the statement,” reports the Cincinnati Business Courier. “The six-hospital Mercy Health leases Mercy Franciscan Terrace from the Franciscan Sisters of the Poor. The senior health and housing facility is located on the campus of the Sisters’ Mother House.” Read more…

“The U.S. House Oversight and Government Reform Committee’s report, “Billions of Federal Tax Dollars Misspent on New York’s Medicaid Program,” said roughly 60 percent of Medicaid applicants in Suffolk County — on Long Island — engage in estate planning to gain Medicaid eligibility,” reports UPI.com.

“There are various legal means to prevent those funds from being used to pay for the applicant’s nursing home care. Wealthy applicants for Medicaid’s nursing home coverage consider that benefit to be their right, regardless of their ability to pay themselves … Individuals with resources above and beyond the level prescribed by law should not be allowed to fund their children’s inheritance while the taxpayers fund their nursing home care,” said Janice Eulau, assistant administrator of the Medicaid Services Division at the Suffolk County Department of Social Services in her testimony before the committee. Read more…

“Florida welfare officials are proposing a bill that targets Medicaid fraud among patients who hide their assets with family and friends to get the taxpayer-funded program to pay for their nursing home care,” reports the Associated Press for The Miami Herald. “The agency tracked 538 cases over six years and found that Medicaid spent more than $29 million in services for people whose spouses were financially stable but had signed over financial support to the state so Medicaid would pay for the nursing home. Officials could have recovered $24 million from those spouses under federal law, but the state currently lacks a process to do, DCF officials said.” Read more…

“Wyoming lawmakers are considering allowing assisted living facilities to provide a higher level of care for their residents so they can avoid having to move to nursing homes,” reports Trib.com. “A House committee voted 5-4 on Tuesday to send the bill to the full House for debate. The Senate has already passed the bill, which is sponsored by Sen. Charles Scott, a Republican from Casper. The bill would allow the facilities to care for people with open skin lesions, catheters and occasional bladder problems. It would also allow staffers to help those who need supplemental oxygen.” Read more…

“The second of six assisted living facilities in the region once operated by Scott Schuett is set to close at the end of February. Madison Retirement Center in Williamsburg has been operating on an expired conditional license since March 2012 while Schuett appealed its non-renewal,” reports the Daily Press. “About 30 residents, a mix of those receiving state auxiliary housing grants and private pay, will be displaced by its closing, according to Trish Meyer, regional licensing administrator for the Department of Social Services. Schuett previously closed Governor’s Inn in Newport News in November.” Read more…

“In January the North Valley Health District abruptly announced it was closing the [Tonasket North Valley Assisted Living Facility] because it was hemorrhaging money,” reports King5.com. “The district also operates a nursing home and hospital. Now, $2 million in debt, administrators say the only way for them to avoid a complete collapse of health care in the community is to shut the center down.” Read more…

“[The Fountain] a troubled Youngtown assisted-living facility is closing today after two chaotic weeks in which its license was revoked, staff was fired and nearly 50 residents scrambled to find new homes,” reports AZCentral.com. “The Fountain was on a provisional license before it was revoked Tuesday, days before the facility was already slated to close. The state moved to revoke the license after a mix-up over layoff notices left two caregivers to tend to 40 residents on Feb. 16. Residents were put in immediate danger because of the two-week notice to vacate the premises. Typically, residents get at least 30 days notice in similar situations.” Read more…

“More than 110,000 CalPERS policyholders are receiving similar news [of an 85% rate increase for their long-term care insurance policies] after the pension fund’s board approved the changes late last year,” reports The Los Angeles Times. “CalPERS said the hefty rate hikes won’t take effect until 2015 and are necessary to keep this $3.6-billion insurance fund intact for future claims. This CalPERS program, like other plans sold by private insurers, has been plagued by higher-than-expected claims, lower investment returns and poor pricing.” Read more…

SeniorHomes.Com Launches Consumer Reviews

SeniorHomes.com, an online directory for senior care and housing, has launched consumer review abilities on its website, allowing residents, family members of residents, and visitors to post reviews for listed assisted living, independent living, and memory care communities in Washington, Oregon, and Arizona. All other markets will launch in waves throughout 2013, with expectations that the review feature will be active in all 50 states by the end of the year.

The consumer review feature is part of SeniorHomes.com’s efforts to provide objective information to help families make educated decisions related to senior living, says the company. Consumers will also be able to rate communities on specific categories such as activities, food, facility, quality of care, and staff, in addition to writing a review.

Senior living providers will be able to respond to each review that is submitted, allowing them to address issues and interact with consumer feedback.

National Health Investors See Earnings Rise on Senior Living Investments

National Health Investors, Inc. (NYSE: NHI) last week announced its normalized funds from operations rose 9% to $0.84 per diluted share in the fourth quarter, up from $0.77 per share in the previous year period.

Net income attributable to common stockholders for the fourth quarter of the year was $41.1 million or $1.48 per diluted common share compared with $18.1 million or $65 per diluted common share for the same quarter in 2011. NHI noted a gain on sale of $11.97 million for an assisted living facility in New Jersey.

Among the company’s 2012 highlights, NHI counts $178.5 million investments in properties and loans in private pay senior housing assets as well as a new $320 million bank credit facility and a lease extension agreement with its largest customer spanning through 2026.

NHI’s outlook forecasts normalized FFO in the coming year from $3.30 to $3.38 per diluted common share and has added investment assumptions including 6% growth from its Bickford joint venture as well as expectations to make new investments in health care real estate in 2013. (Written by Elizabeth Ecker)

Here’s a collection of news bites pertaining to the senior housing and long-term care industries, gathered from around the nation. Many of the articles are state-specific, but could eventually have national implications or influence senior care trends. Click the links to access the full article.

Emeritus to Hire 1,000 Veterans, Military Spouses

Emeritus Senior Living has announced its plans to hire at least 1,000 former members of the military and military spouses in the next five years, prompted in part by unemployment rates being significantly for veterans than for the overall population.

In January 2013, the jobless rate for all post-9/11 veterans was 11.7%, with military spouses facing a 26% unemployment rate. As of February 2013, the national unemployment rate was 7.8%.

Emeritus’ veteran recruiting program is the first in the nation’s senior living industry.

The Wisconsin Center for Investigative Journalism has launched a project, called A Frail System, exploring issues surrounding “a recent change in state law that bars records of abuse and neglect from use in the courts” that may diminish families’ abilities to hold potentially negligible nursing facilities accountable, reports WisconsinWatch.org. While healthcare providers largely approve of the law, which was introduced by Gov. Scott Walker (R-Wisc.) in a job-creation and retention effort, consumer advocates do not approve. “The law, which went into effect in February 2011, bars families from using state health investigation records in state civil suits filed against long-term providers, including nursing homes and hospices,” says the article. “It also makes such records inadmissible in criminal cases against health care providers accused of neglecting or abusing patients.” Read the latest installment.

“In January, the Wisconsin Department of Health Services began publishing state inspection reports of nursing homes, assisted living facilities and other health care providers on its website. Records are available from July 2012 onward,” writes the Wisconsin Center for Investigative Journalism. ”To access the reports, click here and select Provider Search. A user may search by facility name, location and type.”

“In the wake of a brutal homicide at a Fayette County care facility, state lawmakers are again examining the issue of violent criminals living in Iowa’s nursing homes. The Iowa House is considering a bill that would require care facility administrators to notify patients, visitors, workers and others when a registered sex offender moves into the home. But the bill is silent on violent offenders convicted of crimes that aren’t sexual in nature,” reports the DesMoinesRegister.com. “That’s one concern of the ACLU of Iowa, which opposes the bill in its current form. But the group’s main objection is that the bill doesn’t say where sex offenders will go for care if Iowa’s nursing homes turn them away.” Read more…

“After a contentious debate, the Kentucky Senate approved a bill Wednesday to create a medical review panel to assess lawsuits alleging abuse at nursing homes,” reports the Courier-Journal.com. “Senate Bill 9 would allow for a panel of three doctors, mediated by an attorney, to review evidence in lawsuits being brought against long-term care centers. The panel would then issue an opinion on whether there was a legitimate claim of neglect or abuse that would be admissible in court. The bill would not prevent a case from going to trial, Denton said.” Read more…

“Rather than build its own hospice, nursing home and home health agency, Ohio State University’s Wexner Medical Center is turning to players in the industry for business relationships as Medicare and insurers increase pressure on hospitals to ensure patients stay home when sent home,” reports Columbus Business First. “Responses were due Feb. 13 from senior care organizations, nursing agencies, medical equipment dealers and others asked by Ohio State to provide credentials as the hospital system seeks to expand its “post-acute care continuum of services,” according to a document obtained by Columbus Business First through a public records request.” Read more…

“True to its word, a labor union representing more than 400 employees at Van Duyn Home & Hospital has filed a lawsuit challenging Onondaga County’s transfer of the nursing home to a county-created development corporation. The lawsuit filed late last week in state Supreme Court in Syracuse also challenges budget cuts related to Van Duyn’s potential sale to a private operator, Rockland County-based Upstate Services Group,” reports Syracuse.com. “The union had previously threatened to sue the county over the legality of transferring ownership of the nursing home to what it calls a “nonregulated shell corporation that has little oversight and no accountability to taxpayers.’” Read more…

Here’s a collection of news bites pertaining to the senior housing and long-term care industries, gathered from around the nation. Many of the articles are state-specific, but could eventually have national implications or influence senior care trends. Click the links to access the full article.

“County-run nursing homes across New Jersey are banding together in hopes of getting extra help to stay in business as government funding continues to be reduced,” reports CBS Philly. ”The state Association of Counties decided to set up a separate entity called County Nursing Homes of New Jersey. Executive Director John Donnadio says Medicaid subsidies have been getting cut and the worst is yet to come. “We’re phasing into what’s called ‘Managed Long Term Care’ at some point in 2013, probably in July. And that will reduce the Medicaid reimbursement rates, even less to our county operated nursing homes,” says Donnadio. That could prompt some to sell to private operators, like Burlington and Cumberland Counties did recently.” Read more…

“Nursing homes in western North Dakota are struggling to maintain staffing in the face of a bidding war for workers that is rippling from the booming Oil Patch. Two facilities—one in Williston and another in Underwood—are casualties of the high cost of labor and the problems in keeping staff to care for residents,” reports The Dickinson Press. “Last year, 14 percent of nursing facilities stopped admissions because of insufficient staffing, and 68 nursing facilities reported 751 openings as of July, according to figures from the North Dakota Long Term Care Association.” Read more…

“Advocates for senior programs say more money alone isn’t going to solve structural problems with Pennsylvania’s services for the elderly. Ron Barth, CEO of LeadingAge PA, says if privatizing the Pennsylvania Lottery will guarantee additional funding for senior programs, that’s a plus. The most in-demand programs, however, will still need more, he said Tuesday during a hearing before state lawmakers,” reports Newsworks.com. “Legislators were seeking more information about senior programs supported by lottery profits and a pending contract with Camelot Global Services to take over the lottery’s operations. The British firm is promising higher profits for the lottery over a 20-year period, $34 billion altogether, if it’s also able to expand gambling.” Read more…

“A judge has denied a new trial for the owners of a Lake Worth nursing home who late last year were ordered to pay nearly $2 million to the family of a former patient — marking one of the largest jury awards statewide for a wrongful death case involving a nursing home,” reports The Palm Beach Post. “Former Boynton Beach resident George Dahmer, who for more than 32 years was a professional wrestler under the stage name “Chief White Owl”, died in May 2008 after family members and their attorney Joe Landy say Lake Worth Manor nursing home employees thoroughly neglected him. Lake Worth Enterprises, which has since changed Lake Worth Manor’s name to Oasis, said Dahmer had suffered from multiple diseases and had been treated at four different facilities by the time he died.” Read more…

“Senior care services in Illinois are holding onto what little money they’ve received from the state. It’s caused concern for both employees and their clients who rely on them in their retirement years. ”We’ve had to borrow money to make ends meet. The state is behind on some programs approximately six months behind, on elder abuse, they’re six months behind. On the community care program, they’re three or four months behind which is a huge part of our budget,” Brenda Fleming said,” reports KHQA. “Fleming says she’s asking all of her senior care providers to reevaluate the needs of their clients. It’s the hope they’ll be able to cut back some areas of care to save on funding.” Read more…

“[Hilltop Haven, the] long-time nursing home in the Grayson County community of Gunter, has become a victim of economics. It is scheduled to close mid-March. ”We were unable to find a sustainable financial model for Hilltop,” said Senior V.P. Teresa Scott,” reports WFAA.com. “Ninety percent of Hilltop Haven’s patients are on Medicaid. ”Had the cuts not occurred, we would not be closing,” Scott said. “This was our mission.” This would have been the 66th year for Hilltop Haven. Close to 113 residents would need to find new homes. As of Friday, 25 or so are still in the facility and will need to move out by March 16.” Read more…

Here’s a collection of news bites pertaining to the senior housing and long-term care industries, gathered from around the nation. Many of the articles are state-specific, but could eventually have national implications or influence senior care trends. Click the links to access the full article.

Massachusetts Senate Bill 2139 “Establishes the rights of residents of Continuing Care Retirement Communities (CCRC) to establish a residents’ association and have the power to elect its officers,” writes WickedLocal. “The measure requires the facility to provide information to residents including explaining any adjustments in monthly and other fees paid by residents as well as informing them of all matters that affect their health and welfare.” Read more…

“The flu outbreak that’s sickened thousands of North Texans is an even greater threat to the very young and the elderly– and that’s forcing operators of area senior living centers to take special precautions. “It’s a grave concern,” says Kathy Barone, Executive Director of the Emeritus at Eden Estates senior community in Bedford,” reports the local CBS affiliate. “At Eden Estates, lunch is no longer served in the lavish dining room. It’s delivered to resident’s rooms in disposable containers because of the flu emergency. Gathering areas like the coffee shop and community rooms–typically full of residents–are quiet and empty since they’ve been asked to stay in their apartments. Barone says they’ve had 51 confirmed flu cases since January 4th– that’s more than a third of the residents.” Read more…

“Yesterday, almost 7,000 nursing home workers and members of SEIU Healthcare Pennsylvania who work in 80 facilities across the state initiated their first day of bargaining for new union contracts set to expire this year,” reports WRTA. “Approximately 150 negotiating committee members traveled to Harrisburg to meet with industry representatives from Golden Living Center, Genesis, Extendicare, Reliant and Guardian nursing home chains as well as independent nursing homes. Nursing home leaders will now meet with their co-workers to prepare for continued bargaining throughout the winter.”

“Following a history of problems, a Toledo nursing home has lost its Medicare and Medicaid provider agreements, effectively shutting the home down. Liberty Nursing Center of Toledo, 2005 Ashland Ave., has also been facing the loss of its state license since August for several instances in which staff allegedly failed to prevent and respond to alleged abuse,” reports the Toledo Blade. “The Centers for Medicare & Medicaid Services told Liberty in a letter last month it was being fined at least $36,400, in addition to having its Medicare and Medicaid agreements terminated, effective Jan. 8. Residents must leave Liberty by Feb. 7, said Beverley Laubert, state long-term care ombudsman with the state Department of Aging.” Read more…

“Hebrew SeniorLife (HSL), the largest provider of senior health care and housing communities in New England and an affiliate of Harvard Medical School, announced today a formal collaboration with HouseWorks to deliver non-medical private care services to Hebrew SeniorLife’s private care clients,” reports The Dedham Transcript. ”Under the new collaboration, Hebrew SeniorLife’s private care service will be relaunched as Hebrew SeniorLife Private Care powered by HouseWorks. HouseWorks is a leading provider of in-home private care serving Boston area residents for more than 14 years. Seniors who receive Hebrew SeniorLife Private Care services to help them live at home independently.” Read more…

“Pet owners who were forbidden by Greenwich law from bringing pets to shelters during Hurricane Sandy might have options in case of another emergency thanks to a local nursing home,” reports the Greenwich Daily Voice. “The Nathaniel Witherell, the not-for-profit nursing home owned and operated by the Town of Greenwich, is considering accepting pets and their owners in the event of another town-wide emergency like Hurricane Sandy. State Rep. Fred Camillo, who took in an elderly woman and her dog during Hurricane Sandy because of the town policy, is hoping the town changes its laws before another emergency hits.” Read more…

“Expired facility licenses and a slew of violations, including a lack of qualified administrators, haven’t prevented the continued operation of several assisted living facilities, or ALFs, under the ProPlusCare umbrella in Hampton Roads. Despite ongoing complaints and multiple documented failures to meet the state’s standards, thanks to due process, they can continue to operate and take in new residents until all licensing appeals are exhausted,” reports the Daily Press. “The Department of Social Services, which regulates them, was unable to give a timeline for the process, which in the instance of Madison Retirement Center in Williamsburg has continued for almost a year, since March 2012. Many—including social workers, case managers, and community agency representatives—blame the conditions not on the operator of the assisted living facilities, but on the state’s failure to adequately fund community housing for the mentally ill.” Read more…

Here’s a collection of news bites pertaining to the senior housing and long-term care industries, gathered from around the nation. Many of the articles are state-specific, but could eventually have national implications or influence senior care trends. Click the links to access the full article.

“State records show that 20 percent of Florida’s nursing homes fail to abide by minimum care standards or fail to properly correct identified problems after an inspection,” reports long-term care watchdog organization Families for Better Care. “More than two-dozen cities are home to multiple watch list facilities; those with the highest concentration include Jacksonville (10), Miami (6), Saint Petersburg (6), and Winter Haven (5). Over the last 30 months, some nursing homes have been on the list for months—even years.” Read more…

“Norovirus in long-term care facilities is common. It’s highly contagious. It’s life-threatening for the frail and elderly. And fastidious infection control and disinfection are critical to controlling its spread,” reports the Journal-Sentinel. “Nursing homes with lower ratios of registered nurse staffing had a significantly higher rate of death during norovirus outbreaks in a recent study reported in the Journal of the American Medical Association. No increased risk was observed in nursing homes with higher daily RN hours per resident.” Read more…

“Northview Senior Living Center, Johnstown’s only nursing home, will begin sending out legal notices of the closure next week. Officials did not provide an exact closing date. The center employs 65 and houses 46 residents, the latter of which it will assist in relocating. Employees have been offered severance pay or employment elsewhere, said officials at Zanesville-based Zandex Health Care Corp., which operates Northview,” reports The Columbus Dispatch. “The closure cuts short what might have been a lengthy court battle between Zandex and the village’s zoning board. Zandex officials said they couldn’t afford the fight for Northview, which long had been unprofitable.” Read more…

“Organizations that provide long-term care for the elderly in Illinois operate in a kind of business limbo, unsure of when they’ll receive from the state the Medicaid reimbursements they rely on to keep their doors open. Right now, the payment backlog is about six months, forcing organizations to find creative ways to manage without half of the annual revenue that finances care for two-thirds of patients in nursing homes and about 60 percent of those in assisted-living centers,” reports The State Journal-Register. “Illinois deliberately delays paying its bills in an effort to manage its broken finances. The practice shifts the burden onto all sorts of state contractors, including long-term care facilities, which must borrow money and, in some cases, leave jobs vacant as they wait on the state.” Read more…

“Western Pennsylvania stands out for all the wrong reasons in a new analysis of information about problems at nursing homes. More reports of those problems, or deficiencies as they’re called, were issued in Pittsburgh than any other city in the state, including the much larger Philadelphia,” reports the Post-Gazette. “Inspectors for the U.S. Centers for Medicare and Medicaid Services gave 446 deficiencies to 35 Pittsburgh nursing homes in three years, the data showed. Pittsburgh’s rate of nearly 13 deficiencies per nursing home outpaced the national average of six to seven per inspection, according to CMS. (The deficiencies are graded A through L, with the worst problems receiving the L grade.) Six nursing homes in three counties of Western Pennsylvania — Westmoreland, Allegheny and Lawrence — accounted for the majority of the state’s worst scores from CMS.” Read more…

“The Nevada Rural Housing Authority’s (NRHA) Larios Arms Senior Residence in Winnemucca, Nev., is 100 percent occupied within six months of opening. The 30-unit affordable housing community for senior citizens project is located in eastern Nevada. Leasing began May 21, 2012. The last unit was leased November 21, 2012,” reports Multi-Housing News. “The Nevada Rural Housing Authority partnered with Praxis Consulting Group to provide project development consulting and assist in assembling construction financing by utilizing 9 percent Low Income Housing Tax Credits, State of Nevada HOME funds, an AHP grant from the Federal Home Loan Bank, conventional construction and permanent debt. The development not only addresses a significant need for affordable senior housing in rural Winnemucca, but also provides convenience by placing the development near senior-oriented services.” Read more…

A group of nurses and residents at the Chemung County Skilled Nursing Facility is launching a campaign to protest the idea of privatizing the county-owned facility. Chemung County officials have been considering turning the nursing home, which loses about $500,000 annually, over to a private operator. They’ve spoken to management and staff at the nursing home about the possibility, and mulled hiring a consultant to do a study,” reports The Leader. “But no official steps have been taken, and no final decisions made, Chemung County Executive Tom Santulli said. It’s more expensive for counties to run nursing homes than for private companies, Santulli said. The big reason is the staff at county nursing homes are government employees who receive excellent benefit packages, which are costly to provide. Also, private facilities get higher levels of funding and Medicaid reimbursement, he added.” Read more…

Here’s a collection of news bites pertaining to the senior housing and long-term care industries, gathered from around the nation. Many of the articles are state-specific, but could eventually have national implications or influence senior care trends. Click the links to access the full article.

“Now that President Obama has won a second term, the Supreme Court has ruled the Affordable Care Act constitutional and the election has made Congressional attempts to repeal it unlikely, a few advocates for the elderly are quietly talking about resurrecting the Class Act, or some variant of it,” reports The New York Times: The New Old Age blog. “There’s a window of opportunity now,” said Connie Garner, director of the advocacy group Advance Class. “The stars are lined up to have a productive conversation.” Interestingly, the actuary who lost his job, Robert Yee, agreed that the program could be successful. He had not completed the research when the ax fell, but “from an actuarial perspective, we can make this work,” he told me at the time.” Read more…

“Almost all the states use provider taxes to help fund their Medicaid programs, but the Obama administration says some are essentially using them to game the system — by taxing them, giving the money back and then claiming that money as state spending that the feds have to match,” reports Politico. “That plan would have ratcheted down the amount of Medicaid provider taxes that states are allowed to collect, producing $26.3 billion in federal savings. That’s much less of a sting than the $44 billion in savings recommended by the 2010 Simpson-Bowles deficit commission, which called for the eventual elimination of provider taxes.” Read more…

“Employees said they made a drug discovery on a vending machine inside the Heartland-Fairfield Nursing Center. Fairfield County sheriff’s investigators believe it’s LSD, a hallucinogenic drug popular in the 1960′s, rarely seen circulating in Central Ohio today,” reports 10TV.com. “Detectives said a cleaning crew discovered a sheet of the drug about the size of a business card, during a routine cleaning. They believe it had been there for two or three days. The nursing center turned it over to investigators, who are now working to determine who left it there and why.” Read more…

“Desert Regional Medical Center is looking to close its skilled nursing facility in the first quarter after operating at a loss for at least a year,” reports MyDesert.com. “The 34-bed unit on the fourth floor of the Palm Springs hospital currently houses 15 patients and employs 30 full-time and four part-time employees, said Rich Ramhoff, a hospital spokesman. A definitive date for closure has not yet been set.” Read more…

The Government Accountability Office recently released a study on the Medicaid Integrity Program, conducted because Medicaid has the second-highest estimated improper payments of any federal program reporting such data. The report assesses the efficiency and effectiveness of the Medicaid Integrity Group (MIG), created to oversee and support state program integrity activities. GAO found that CMS should take steps to eliminate duplication in the program to reduce inefficiency related to hiring separate review and audit contractors for MIG’s National Medicaid Audit Program, and made several recommendations to strength and improve the program. Read more.

“A federal judge in Hartford has ordered a Connecticut nursing home chain to reinstate nearly 600 workers who have been on strike since July 3, and to rescind the pension and health care cuts it had imposed,” reports the N.Y. Times. ”Judge Robert N. Chatigny of the United States District Court in Connecticut ruled on Tuesday night that the nursing homes’ owner, HealthBridge Management, had broken the law by refusing to bargain in good faith and by imposing the cuts before a true negotiating impasse had been reached. Judge Chatigny issued an injunction that ordered HealthBridge to reinstate the workers by next Monday, even if it means ousting hundreds of the replacement workers hired to run the nursing homes after the strike began.” Read more…

“Operators of Ohio’s nursing homes and assisted-living centers have 10 months to change their financial model after the state got approval for a pilot program to improve the health and reduce the medical costs for a fragile population disabled enough and poor enough to qualify for both government insurance programs. The government hopes to save $243 million over the program’s three years,” reports Columbus Business First. ”The businesses providing that care hope it’s a true reduction in duplication and unneeded services, rather than a hit to their already slim bottom lines. “In a year, all of our payments are going to shift from the government to private health plans,” said Tom Slemmer, CEO of National Church Residences, the nation’s largest nonprofit developer of affordable senior housing and a LeadingAge member.” Read more…

Technology to facilitate aging in place—whether in the home or in a senior living community setting—continues to make strides, evidenced in this round-up that features a mobile app for caregivers to coordinate care, a new fall-prevention and PERS platform, and a home safety telephone system marketed as an affordable PERS alternative. Also in the news is a federal report faulting Medicare for being vulnerable to fraud and abuse in its shift to implementing electronic medical records, while two health information exchanges seek to prove their benefits ahead of federal funding running out. Read on:

1. Philips: Mobile App Allows Caregivers to Coordinate Care

Royal Philips Electronics (NYSE:PHG) recently released CarePartners Mobile, a new mobile app designed to help family caregivers coordinate care for their loved ones.

“CarePartners Mobile allows people to spend more time caregiving, and less time trying to determine what needs to be done and who is doing it,” said Mark Sabalauskas, senior product manager, Philips Lifeline. “The app also taps in to the growing trend of using mobile technology to communicate, organize our lives and improve our health. As this trend continues to grow, Philips is leading the way, providing services where and how they are most effectively delivered.”

The free app, which is available for iPhone and Android, streamlines care coordination, and enables caregivers to create, manage, and view upcoming caregiving tasks using a shared to-do list, assign tasks to individuals and see what tasks still need volunteers, and syncs tasks they’re responsible for directly to smartphone calendars, among other functions.

“Two health information exchanges—The Great Lakes HIE in Michigan and the Keystone HIE in Pennsylvania—are throwing technology at a major meaningful use policy paradox that affects vulnerable, elderly patients at the worst possible times. By doing so, they could be demonstrating the type of health information exchange benefits that privately and publicly funded HIEs have been seeking in order to prove their economic viability as federal grants are due to expire,” writes SearchHealthIT. “Nursing homes were left out of federal EHR incentives, but they’re the parties who typically hold their patients’ up-to-date advance directives. When these patients—some of them incapable of making their own health care decisions—get ambulanced to hospitals or go to doctors’ offices for treatments, their caregivers are required to collect advance directives from 50% of patients, per the stage 2 meaningful use criteria.” Read more…

3. New York Times: Medicare Faulted on Shift to Electronic Records

“The conversion to electronic medical records—a critical piece of the Obama administration’s plan for health care reform—is “vulnerable” to fraud and abuse because of the failure of Medicare officials to develop appropriate safeguards, according to a sharply critical report to be issued Thursday by federal investigators,” reports The New York Times. “…the report says Medicare, which is charged with managing the incentive program that encourages the adoption of electronic records, has failed to put in place adequate safeguards to ensure that information being provided by hospitals and doctors about their electronic records systems is accurate.” Read more…

4. Care Technology Systems: New Fall-Prevention Platform

Care Technology Systems, Inc.’s newest product offering is an Active-PERS device that has been added to its Fall Detection by Logic System.

The new pendant can help caregivers respond to falls in a timelier fashion, even if the senior fails or is unable to press the pendant’s alert button. Here’s how it works:

“While standard PERS requires the user to push a button to notify caregivers of a fall, we know that in 83% of the times a senior who uses PERS isn’t wearing their pendant, and can’t alert others when they’ve fallen,” said Jim Anderson, founder and president of Care Technology Systems. “So, we’ve integrated an accelerometer that actively monitors senior activity as a part of a larger alert system and can tell us whether a fall has occurred and automatically summon help.”

The system also can receive activity information from the device on a regular basis, called Motion Scoring, that can track patterns to help predict falls and thus prevent them. This could result in significant healthcare cost savings, Care Technology Systems believes, especially as hospitalization costs for falls average around $17,500, according to recent statistics.

5. VTech: CareLine Phone System for Independent Senior Living

VTech Communications, a subsidiary of VTech Holdings Ltd. (HKSE:303), recently introduced the CareLine home safety telephone system meant for seniors still living at home. The system’s features are designed to meet seniors’ daily communication needs and include large displays, reminder capabilities, volume boost, and a wearable pendant with one-button dialing that directly calls people that seniors communicate with most. VTech is marketing the system as an affordable alternative to a PERS (personal emergency response system).

The pendant allows users to make and receive calls, listen to voicemail messages, review missed calls, confirm the date and time or receive programmed reminders for medication, appointments, or other events. The user or a family member can set reminders directly through the corded phone base or with a phone call; when it’s the set time, the system will remind the user with a light and audio cue. The pendant can also be used to get immediate emergency assistance. Users can press one of two speed-dial keys or use a voice command to call self-programmed contacts such as 911, a family member, or trusted friend or neighbor.

Here’s a collection of news bites pertaining to the senior housing and long-term care industries, gathered from around the nation. Many of the articles are state-specific, but could eventually have national implications or influence senior care trends. Click the links to access the full article.

“Impending reimbursement cuts will threaten profitability as most of the revenues from skilled nursing and assisted living facilities are from Medicare and Medicaid. To reduce costs, the new law also encourages patients to receive home care services, which are less expensive than receiving skilled nursing or assisted living care. To remain profitable, facilities may have to raise prices for private pay patients to offset the losses from government reimbursements,” reports Becker’s Hospital Review.

“General recommendations for skilled nursing and assisted living facilities to prepare themselves financially for healthcare reform include changing a facility’s business model to diversify revenue streams, bundling services and contracting with larger providers. However, to succeed at accountable care, facilities will need to successfully manage high acuity care at a lower cost and reduce hospitalizations.” Read more…

“The California experiment, now in its second year, has national significance. Federal officials have begun to roll out a similar, but larger effort required by the Affordable Care Act. That program will move up to 2 million of the nation’s sickest and most expensive patients into managed care. Twenty-five states have applied to be part of the managed care experiment for so-called “dual-eligibles,” people who qualify for both Medicare and Medicaid. All dual-eligibles are poor, two-thirds of them are over 65, and many of them suffer from multiple chronic illnesses like diabetes and heart disease,” reports Kaiser Health News. “Those are sound principles, but the size of the experiment worries many. “They are too big to fail,” says Robert Berenson, a former vice chairman of the Medicare Payment Advisory Board.” Read more…

“House Bill 153 was implemented in July 2011, the beginning of the state fiscal year. It rebalanced funding for long-term care by cutting Medicaid rates paid to nursing homes by about 6 percent. It was one of the largest budget cuts in recent years,” reports Vindy.com. ”Then in October 2011, Medicare cut funding by an average of 11 percent nationally, claiming it had underestimated the cost of changes made in skilled nursing facilities the year before. Some Ohio facilities faced cuts of up to 12 percent. These two major cuts within six months proved challenging for many facilities, said Peter Van Runkle, executive director for the Ohio Health Care Association, which represents 750 long-term and special care facilities in Ohio.” Read more…

“AARP, the highly influential lobby for older Americans, is fiercely opposing any Medicare or Social Security cuts and emphasizes that it is fighting for the good of its members. But the proposals for changing Medicare also could affect AARP’s bottom line,” reports The Washington Post. ”AARP has long played a dual role. It advocates for the interests of seniors, and it makes money allowing its name to be used in selling them private insurance, including coverage known as ­Medigap, which supplements government-provided Medicare. The group gets a 4.95 percent royalty each time someone buys Medigap insurance with the AARP brand.” Read more…

“[A]ssisted-living facilities, which are mostly privately funded, don’t face the same penalties [as federally-certified nursing homes receiving Medicare funding]. “There’s really not any kind of strong enough repercussions, particularly in assisted living facilities,” said state Sen. Capri Cafaro of Liberty, D-32nd. “You either get a slap on the wrist or shut down completely.” Cafaro hopes to introduce legislation in the next session of the Ohio General Assembly that would allow the Department of Health to fine assisted-living facilities,” reports Vindy.com. “[Regional director of the state Department of Aging's Long-term Care Ombudsman Program John] Saulitis is working with Cafaro and the Ohio Department of Aging on research for a law that would allow the Department of Health to fine assisted- living facilities.” Read more…

“A Republican proposal to raise the eligibility age for Medicare may save the federal government more than $100 billion while increasing health-care costs to senior citizens, states and employers. People age 65 and older could pay an extra $2,000 for health insurance if they’re excluded from Medicare, the federal health-care program for the elderly, according to the nonpartisan Kaiser Family Foundation,” reports Bloomberg. ”Other government and private health plans would see costs rise as would-be Medicare recipients seek care elsewhere. Savings to the government would accumulate slowly as Medicare began paying benefits to fewer people. The Treasury would collect more in Medicare payroll taxes because many seniors previously eligible for the program would keep working instead, to retain their health insurance. By 2035, the change would reduce projected Medicare spending by 5 percent, according to the CBO.” Read more…

“Why are older people especially vulnerable to becoming victims of fraud? A new UCLA study indicates that an important clue may lie in a particular region of the brain that influences the ability to discern who is honest and who is trying to deceive us,” writes Medical News Today. “Older people, more than younger adults, may fail to interpret an untrustworthy face as potentially dishonest, the study shows. The reason for this, the UCLA life scientists found, seems to be that a brain region called the anterior insula, which is linked to disgust and is important for discerning untrustworthy faces, is less active in older adults.” Read more…

Last month, Medicare began issuing penalties to hospitals with what it believed had “one too many readmissions,” writes the New York Times in an article this week.

The article discloses Medicare addressed 2,217 hospitals, with 307 of those receiving the maximum punishment of a 1% reduction in the program’s regular payments for every patient over the next year.

The crackdown on readmissions derives from the effort to eliminate unnecessary Medicare spending, which the Congressional Budget Office noted reached $556 billion this year. The penalties are believed to garner $300 million this year, but the goal, according to the article, is to pressure hospitals in paying closer attention to patients after discharge to minimize chances of readmission.

“With nearly one in five Medicare patients returning to the hospital within a month—about two million people a year—readmissions cost the government more than $17 billion annually.

Hospitals’ traditional reluctance to tackle readmissions is rooted in Medicare’s payment system. Medicare generally pays hospitals a set fee for a patient’s stay, so the shorter the visit, the more revenue a hospital can keep. Hospitals also get paid when patients return. Until the new penalties kicked in, hospitals had no incentive to make sure patients didn’t wind up coming back.

The maximum penalty is set to double next October and then reach 3 percent of reimbursements in October 2015. Medicare also is expanding the list of conditions it will assess in setting punishments.

With pressure to avert readmissions rising, some hospitals have been suspected of sending patients home within 24 hours, so they can bill for the services but not have the stay counted as an admission.”